Effort to End Therapy Cap Enters Crucial Stage

The APTA grassroots campaign to end the Medicare therapy cap and sustainable growth rate (SGR) formula has intensified in light of the looming 60-day deadline for Congress to take action, with the association calling on physical therapists (PTs), physical therapist assistants (PTAs), patients, and supporters to add their voices now to the movement advocating for long-overdue changes.

Congress has until December 31 to address the Medicare therapy cap. If no action is taken by then, a hard cap on outpatient therapy services could go into effect in 2014. Similarly, if no action is taken on the SGR, providers could face a 24% reduction in payments.

While the Senate Finance and House Ways and Means Committees released a legislative framework for SGR reform last week, the draft did not include a repeal of the Medicare therapy cap. Language in the draft does indicate that the committees are continuing to look at the Medicare extenders to reach a bipartisan, bicameral agreement, making grassroots advocacy especially important at this stage in the process. APTA urges its members and all other supporters to contact their legislators as soon as possible and ask them to permanently fix the cap in the sustainable growth rate (SGR) reform package, or if such a change isn't possible this year, to extend the therapy cap exceptions process through 2014.

APTA has several tools that make it easy to contact legislators. Members can take action on their computers using the Legislative Action Center and can even sign up for an e-mail reminder alert by joining the PTeam. Patients and nonmembers can e-mail their legislators using the Patient Action Center.

PTs Have 'Tremendous Opportunity' in Medicare's Shift to Quality Reporting

While the media focuses on high-profile website problems and political debates, physical therapists (PTs) may find that for them, some of the biggest news around the Patient Protection and Affordable Care Act has to do with how payment systems will emphasize quality of care—and how that quality will be measured. The role of the PT in the new health care reporting landscape is the focus of an article (member login required) in the November issue of PT in Motion, the magazine of APTA.

The Centers for Medicare and Medicaid Services (CMS) are making a "fundamental shift in the health care system" toward quality measurement, writes Heather Smith, PT, MPH, APTA program director of quality. She states that these quality measures "afford PTs a tremendous opportunity to demonstrate their value in the health care system" by delivering the kinds of outcomes that will be of increasing importance in future reimbursement models. The Medicare quality reporting programs are likely to influence reporting among private payers, making the PT's role even more crucial.

Smith's article includes an overview of the health care settings that have adopted quality programs, explanations of the aims and strategies of the move toward quality reporting, and definitions of the various measure categories. PT in Motion is available free to APTA members in both online and print versions.